Amber House

Amber House is established over five floors and had two large communal areas, along with a large garden space. Amber House can provide support for up to seven adults and at the time of inspection, there were seven people living at the home.

People’s experience of using this service and what we found

Risk assessments were completed and provided staff with clear guidance in how to enable and support people to safely take part in events which interested them. This promoted people’s independence, choice and control of their day to day activities. One relative told us, “[Person] has come on leaps and bounds since living here. They are always safe and well, and I have no concerns.”

Staff demonstrated good knowledge of safeguarding and how to recognise the signs of abuse or neglect. Staff had reported concerns when necessary and reported to feel confident in doing so. Staff and management had engaged appropriately with the local authority and other external bodies when needed.

People spoke positively about the running of the service and approachability of the management team. People had the opportunity and felt able to raise concerns, and were assured these would be listened to and acted upon.

The registered manager and senior team had undertaken audits in order to recognise patterns or trends in accidents or incidents. This enabled them to put measures in place to minimise risk and aid learning and development of staff.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support:

• Model of care and setting maximises people’s choice, control and independence. The service encouraged people to be involved in activities in the home. For example, people were encouraged to be part of the cleaning regime and some people were able to assist in meal preparation with support from staff.

Right care:

• Care is person-centred and promotes people’s dignity, privacy and human rights. Staff knew people well and we saw they treated them with respect and dignity. People’s care plans highlighted what they liked and disliked, and support was unique to their wishes.

Right culture:

• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives. People told us that they had regular house meetings where they could discuss any concerns that they may have and give their view on the support they received. People spoke fondly of the management and staff.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 11 July 2019).

Why we inspected

We undertook this targeted inspection to check on a specific concern we had about risk assessment and management within the home. The overall rating for the service has not changed following this targeted inspection and remains good.

CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Amber House accommodates seven people in one adapted building supporting people with Prader-Willi Syndrome (PWS). PSW causes low muscle tone with consequent motor developmental delays, a mild to moderate learning difficulty, incomplete sexual development, and emotional and social immaturity, leading to behaviours that can challenge. During childhood, an overwhelming and insatiable chronic appetite usually develops which, without rigorous food management and exercise regimes, leads to food seeking, stealing and life threatening obesity. Instead of the main characteristics of this syndrome is, learning disabilities ranging from severe to borderline and people experience an excessive appetite.

The home is situated in St Leonards-By-Sea and on the day of inspection there were six people living at there. Amber House is located over five floors which are accessible via stairs. The home had two large communal areas and a garden at the rear of the home.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service:

Systems supported people to stay safe and reduce the risks to them, ensuring they were cared for in a person-centred way. People and relatives told us they felt the home was a safe place to be and felt comfortable to raise concerns with staff. A relative told us, “I feel very confident that my son is safe at Amber House and the staff are very good.” Staff had a good understanding of how to identify and respond to any suspicion or allegation of abuse.

Staff had a good understanding of the care and support needs of people and had developed positive relationships with them. People were supported to live as independently as possible and told us that their needs were met. Activities took place on a daily basis and people were encouraged to participate if they wanted to. One person told us, “I choose what I want to do.” Relatives and visitors were welcomed and given the privacy to talk to their loved one.

People's needs were effectively met because staff had the training and skills they needed to do so. Specialist training was provided to ensure people's needs could be met and refresher courses were booked when due. This included in depth training on PWS, which is a genetic disorder where people are constantly hungry. One person told us, “Staff are trained well and have good understanding of my condition.”

People and relatives told us that staff treated them with kindness and we observed friendly interactions throughout the day. People were supported to ensure their health needs were responded to and health needs were reviewed on a regular basis. People had their privacy and dignity protected.

People were happy with the food and said they were given a choice of home cooked meals. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

The provider had quality assurance systems in place to monitor the standard of care and drive improvement. People, relatives and staff spoke positively about the culture of the home and said it was well managed. One relative told us, “I really do I think the management is very good and they have everything just about right.”

More information is in Detailed Findings below.

Rating at last inspection: This was the first inspection of Amber House since it was registered by the Care Quality Commission (CQC) on 3 May 2018. New services are assessed to check they are likely to be safe, effective, caring, responsive and well-led when registering.

Why we inspected: This was a scheduled inspection

Follow up: We will continue to monitor the intelligence we receive about this home and plan to inspect in line with our re-inspection schedule for those services rated Good.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.